Are primary care services a substitute or complement for specialty and inpatient services?

Health Services Research

Volumn 40, Issue 5 I, 2005, Pages 1422-1442

  Fortney, John C ^a,b   Steffick, Diane E ^a,b   Burgess Jr , James F ^c,d   Maciejewski, Matt L ^e,f   Petersen, Laura A ^g,h  

^a CENTRAL ARKANSAS VETERANS HEALTHCARE SYSTEM   (United States)

^b UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES   (United States)

^c DEPARTMENT OF VETERANS AFFAIRS   (United States)

^d BOSTON UNIVERSITY   (United States)

^e VA PUGET SOUND HEALTH CARE SYSTEM   (United States)

^f UNIVERSITY OF WASHINGTON   (United States)

^g Houston Center for Quality of Care and Utilization Studies   (United States)

^h BAYLOR COLLEGE OF MEDICINE   (United States)

Author keywords

Cost; Managed care; Primary care; Service substitution

Indexed keywords

ARTICLE; HEALTH CARE ACCESS; HEALTH CARE COST; HEALTH CARE NEED; HEALTH CARE SYSTEM; HEALTH SERVICE; HOSPITAL PATIENT; MANAGED CARE; MEDICAL SPECIALIST; MENTAL HEALTH CARE; OUTPATIENT; PRIMARY MEDICAL CARE; REGRESSION ANALYSIS;

ADULT; AGED; CATCHMENT AREA (HEALTH); COMMUNITY HEALTH CENTERS; FEMALE; GEOGRAPHY; HEALTH CARE COSTS; HEALTH SERVICES ACCESSIBILITY; HEALTH SERVICES NEEDS AND DEMAND; HEALTH SERVICES RESEARCH; HOSPITALS, VETERANS; HUMANS; MALE; MIDDLE AGED; PRIMARY HEALTH CARE; SPECIALTIES, MEDICAL; UNITED STATES; UNITED STATES DEPARTMENT OF VETERANS AFFAIRS;

EID: 26644457409     PISSN: 00179124     EISSN: None     Source Type: Journal    
DOI: 10.1111/j.1475-6773.2005.00424.x     Document Type: Article

References (39)

1. Ash, A. S., R. P. Ellis, G. C. Pope, J. Z. Ayanian, D. W. Bates, H. Burstin, L. I. Iezzoni, E. MacKay, and W. Yu. 2000. "Using Diagnoses to Describe Populations and Predict Costs." Health Care Financing Review 21 (3): 7-28.
2. Bindman, A. B., K. Grumbach, D. Osmond, M. Komaromy, K. Vranizan, N. Lurie, J. Billings, and A. Stewart. 1995. "Preventable Hospitalizations and Access to Health Care." Journal of the American Medical Association 274 (4): 305-11.
3. Bound, J., D. A. Jaeger, and R. M. Baker. 1995. "Problems with Instrumental Variables Estimation When the Correlation between the Instruments and the Endogenous Explanatory Variables Is Weak." Journal of the American Statistical Association 90 (430): 443-50.
4. Cooke, B. E. M. 1995. "Health Promotion, Health Protection, and Preventive Services." Primary Care 22 (4): 555-64.
5. Coulter, A. 1996. "Why Should Health Services Be Primary Care-Led?" Journal of Health Services & Research Policy 1 (2): 122-4.
6. Donaldson, M. S., K. D. Yordy, K. N. Lohr, and N. A. Vanselow. 1996. Primary Care: America's Health in a New Era. Washington, DC: National Academy Press.
7. Falik, M., J. Needleman, B. L. Wells, and J. Korb. 2001. "Ambulatory Care Sensitive Hospitalizations and Emergency Visits: Experiences of Medicaid Patients Using Federally Qualified Health Centers." Medical Care 39: 551-61.
8. Fontana, S. A., R. R. Love, C. Helberg, and L. C. Baumann. 1997. "The Delivery of Preventive Services in Primary Care Practices According to Chronic Disease Status." American Journal of Public Health 87 (7): 1190-6.
9. Forrest, C. B., P. Nutting, J. J. Werner, B. Starfield, S. von Schrader, and C. Rohde. 2003. "Managed Health Plan Effects on the Specialty Referral Process: Results from the Ambulatory Sentinel Practice Network Referral Study." Medical Care 41 (2): 242-53.
10. Fortney, J., B. M. Booth, M. Zhang, J. Humphrey, and E. Wiseman. 1998. "Controlling for Selection Bias in the Evaluation of Alcoholics Anonymous as Aftercare Treatment." Journal of Studies on Alcohol 59: 690-7.
11. Fortney, J., K. Rost, and J. Warren. 2000. "Comparing Alternative Methods of Measuring Geographic Access to Health Services." Health Services and Outcomes Research Methodology 1 (2): 173-84.
12. Fortney, J., K. Rost, M. Zhang, and J. Pyne. 2001. "The Relationship between Quality and Outcomes in Routine Depression Care." Psychiatric Services 52 (1): 56-62.
13. Fortney, J., M. L. Maciejewski, J. Warren, and J. F. Burgess. 2005. "Does Improving Geographic Access to VA Primary Care Services Impact Patients' Patterns of Utilization and Costs?" Inquiry 42 (1): 29-42.
14. Frame, P. S., A. O. Berg, and S. Woolf. 1997. "U.S. Preventive Services Task Force: Highlights of the 1996 Report." American Family Physician 55 (2): 567-76.
15. Gill, J. M., and A. G. Mainous III. 1998. "The Role of Provider Continuity in Preventing Hospitalizations." Archives of Family Medicine 7: 352-7.
16. Gill, J. M., A. G. Mainous III, and M. Nsereko. 2000. "The Effect of Continuity of Care on Emergency Department Use." Archives of Family Medicine 9: 333-8.
17. Goodman, D. C., E. Fisher, T. A. Stukel, and C. Chang. 1997. "The Distance to Community Medical Care and the Likelihood of Hospitalization: Is Closer Always Better?" American Journal of Public Health 87 (7): 1144-50.
18. Greene, W. H. 1993. Econometric Analysis. Englewood Cliffs, NJ: Prentice-Hall.
19. Hall, W. D., C. M. Ferrario, M. A. Moore, J. E. Hall, J. M. Flack, W. Cooper, J. D. Simmons, B. M. Egan, D. T. Lackland, M. Perry Jr., and E. J. Roccella. 1997. "Hypertension-Related Morbidity and Mortality in the Southeastern United States." American Journal of the Medical Sciences 313 (4): 195-209.
20. Harris, K. M., and D. K. Remler. 1998. "Who Is the Marginal Patient: Understanding Instrumental Variables Estimates of Treatment Effects." Health Services Research 33 (5, Part 1): 1337-60.
21. Kizer, K. W. 1996. "Prescription for Change: The Guiding Principles and Strategic Objectives Underlying the Transformation of the Veterans Healthcare System." Veterans Health Administration (VHA): 1-50.
22. Lu, M. 1999. "The Productivity of Mental Health Care: An Instrumental Variable Approach." The Journal of Mental Health Policy & Economics 2 (2): 59-71.
23. Manning, W. G., J. P. Newhouse, N. Duan, E. B. Keeler, A. Leibowitz, and M. S. Marquis. 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment." American Economic Review 77 (3): 251-77.
24. McClellan, M., B. J. McNeil, and J. P. Newhouse. 1994. "Does More Intensive Treatment of Acute Myocardial Infarction in the Elderly Reduce Mortality? Analysis Using Instrumental Variables." Journal of the American Medical Association 272 (11): 859-66.
25. Newhouse, J. P., and M. McClellan. 1998. "Econometrics in Outcomes Research: The Use of Instrumental Variables." Annual Review of Public Health 19: 17-34.
26. Petersen, L. A., H. R. Burstin, A. C. O'Neil, E. J. Orav, and T. A. Brennan. 1998. "Nonurgent Emergency Department Visits: The Effect of Having a Regular Doctor." Medical Care 36: 1249-55.
27. Phelps, C. E. 1992. Health Economics. New York: HarperCollins.
28. Phibbs, C. S., and H. S. Luft. 1995. "Correlation of Travel Time on Roads versus Straight Line Distance." Medical Care Research and Review 52 (4): 532-42.
29. Phibbs, C. S., W. Yu, F. A. Lynn, and P. G. Barnett. 2003. "HERC's Outpatient Average Cost Dataset for VA Care: Fiscal Years 1998-2001." Available at http://www.herc.research.med.va.gov/ HERC%20Average%20Cost%20Outpatient%20Documentation%201998-2001.pdf
30. Ricketts, T. C., R. Randolph, H. A. Howard, D. Pathman, and T. Carey. 2001. "Hospitalization Rates as Indicators of Access to Primary Care." Health & Place 7: 27-38.
31. Roman, S. H., and M. I. Harris. 1997. "Management of Diabetes Mellitus from a Public Health Perspective." Endocrinology and Metabolism Clinics of North America 26 (3): 443-74.
32. Rubenstein, L. V., E. M. Yano, A. Fink, A. B. Lanto, B. Simon, M. Graham, and A. S. Robbins. 1996. "Evaluation of the VA's Pilot Program in Institutional Reorganization toward Primary and Ambulatory Care: Part I, Changes in Process and Outcomes of Care." Academic Medicine 71 (7): 772-83.
33. Staiger, D., and J. H. Stock. 1997. "Instrumental Variables Regression with Weak Instruments." Econometrica 65 (3): 557-86.
34. Starfield, B. 1994. "Is Primary Care Essential?" Lancet 344 (8930): 1129-33.
35. -. 1996. "A Framework for Primary Care Research." Journal of Family Practice 42 (2): 181-5.
36. Thompson, R. S. 1996. "What Have HMOs Learned About Clinical Prevention Services? An Examination of the Experience at Group Health Cooperative of Puget Sound." Milbank Quarterly 74 (4): 469-509.
37. Wagner, T. H., S. Chen, and P. G. Barnett. 2003. "Using Average Cost Methods to Estimate Encounter-Level Costs for Medical-Surgical Stays in the VA." Medical Care Research and Review 60 (3 suppl): 15S-36S.
38. Weinberger, M., E. Z. Oddone, and W. G. Henderson. 1996. "Does Increased Access to Primary Care Reduce Hospital Readmissions?" New England Journal of Medicine 334 (22): 1441-7.
39. Welch, W. P., M. E. Miller, H. G. Welch, E. S. Fisher, and J. E. Wennberg. 1993. "Geographic Variation in Expenditures for Physicians' Services in the United States." New England Journal of Medicine 328 (9): 621-7.